Abstract
Brachytherapy (BT) represents an essential aspect of radical radiotherapy of cervical cancer. Within the last decade, 3D MRI-based BT was introduced into clinical practice at some institutions and it was shown that this advanced approach could successfully replace the traditional 2D x-ray-based methods of treatment planning. MRI has general advantages in the depiction of soft tissue and, in particular, in discrimination of cervical cancer from normal uterine and adjacent tissue. Accurate representation of pelvic anatomy and topography, together with detailed information regarding tumor extent and regression during the course of treatment, makes MRI essential for cervical cancer radiotherapy, particularly for BT. The process of implementation of 3D MRI-based BT is described in detail. The first reported single institutional retrospective analysis with systematic utilization of this novel treatment approach in a large consecutive patient series (n = 145) demonstrated the increase in local tumor control up to almost 100% for limited size tumors (2–5 cm) and 90% for tumors over 5 cm in diameter with a low rate of severe late morbidity (<5%).
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Financial & competing interests disclosure
The Department of Radiotherapy at the Medical University of Vienna receives financial and/or equipment support for research and educational purposes from Nucletron B.V., Varian Medical Systems, Inc., and Isodose Control BV The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.